We reported an angioarchitectural classification of the lower esophagus by a selective left gastric venography in 1989; palisading and bar types. The purpose of this project was to investigate the clinical significance of the vascular pattern of the lower esophagus.We examined the clinical characteristics, percutaneous trans-hepatic portography, endoscopic findings, color doppler echography, and non-invasive esophageal variceal pressure measurement and so on in 1,200 patients with esophageal varices. The bar type of the esophageal varices was likely to be resistent to sclerotherapy and easily to recur after the treatment, especially "giant-bar type" esophageal varices should be considered a combined therapy of sclerotherapy with Hassab's operation.以上より,胃食道静脈瘤の治療においては,胃及び食道静脈瘤の血流パターンを中心とした局所の門脈血行動態を把握することが治療方針を決定する上で最も重要であり,治療困難症例においては集学的治療の検討が必要であると考えられた。